Basic Information
| Provider Information | |||||||||
| NPI: | 1467686220 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DAVIS | ||||||||
| FirstName: | AUDREY | ||||||||
| MiddleName: | HOPKINS | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10 S 9TH ST | ||||||||
| Address2: | STE 4 | ||||||||
| City: | NOBLESVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 460602631 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7655243946 | ||||||||
| FaxNumber: | 3177086496 | ||||||||
| Practice Location | |||||||||
| Address1: | 2810 AMBASSADOR CAFFERY PKWY | ||||||||
| Address2: | |||||||||
| City: | LAFAYETTE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 705065906 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3379812949 | ||||||||
| FaxNumber: | 3379896759 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2009 | ||||||||
| LastUpdateDate: | 10/27/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OTT.200179 | LA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.